Association between habitual sleep duration and blood pressure and clinical implications: A systematic review

Elucidation of the association between short sleep duration and elevated blood pressure has implications for assessing and managing hypertension in adults. Objective. To assess the relationship between sleep duration and blood pressure, and its role in the etiology of hypertension. Methods. On a systematic search from MEDLINE, EMBASE, CINAHL, PEDro, PsychINFO and grey literature were included articles with participants over 18 years, reported sleep duration, measured blood pressure or diagnosed hypertension, and the relationship between sleep duration and blood pressure was analyzed. Results. Of 2522 articles initially identified, 11 studies met the inclusion criteria. Sample sizes ranged from 505 to 8860 (aged >= 0-98 years). Five studies (aged >= 58-60 years) determined that sleep duration and blood pressure were unrelated. In younger adults, five studies reported an association between short sleep duration and hypertension before adjustment for confounding variables; only the findings from one study remained significant after adjustment. Two studies supported a sex association; women who sleep less than 5-6 h nightly are at greater risk of developing hypertension. Conclusion. Sleep duration and blood pressure are associated in both women and adults under 60 years. Controlled studies are needed to elucidate confounding factors and the degree to which sleep profiles could augment diagnosis of hypertension and sleep recommendations to prevent or manage hypertension.